The Analgesic Efficacy of Tramadol as a Pre-Emptive Analgesic in Pediatric Appendectomy Patients

Preemptive analgesia is defined as administration of analgesic agents prior to surgery to prevent development of central nervous system hypersensitization thus, preventing decrease in pain threshold.The purpose of this study is to evaluate preemptive efficacy and safety of lower doses of tramadol on children undergoing appendectomy.Methods: This study was performed in 32subjects.First group was given placebo, the second group was given tramadol 0.5mg/kg and the third group was given tramadol 1mg/kg.Pain assessment was done using FACES Pain Scoring (FPS) for </=6years of age and Visual Analog Scale (VAS) for >6years of age.Heart rate and mean arterial pressure during and after anesthesia, post operative nausea and vomiting (PONV) and rescue pain medications given post surgery were recorded.Results: The comparison of age and sex between the three groups showed that there was no significant difference noted as proven by all p values >0.05.There was a significant decrease at both heart rate and mean arterial pressure in each group of tramadol (0.05mg/kg and 1mg/kg) but not significant in comparing between the 0.5mg and 1 mg results.There was no significant difference noted in proportion of subjects with nausea and/or vomiting as proven by all p values >0.05.There was a significant difference noted in both FPS and VAS scores between placebo and tramadol groups 15 and 30minutes post surgery proven by all p values ≤0.05.However, there was no significant difference noted in the FPS and VAS scores between the 2 tramadol groups as proven by p values 0.37 and 0.23 respectively.Conclusion: Tramadol at low doses has the same efficient analgesic effect that could be used as preemptive analgesia for appendectomy of children which provides good intraoperative and early post operative analgesia.